[Implantation of a vascular access device in cancer treatment: operation or angiographic technic?]

Thirty cancer patients, who were diagnosed to be beyond the operable stage, were treated by intra-arterial anticancer agent infusion via an implantable vascular access device (VAD) combined with local hyperthermia and/or charcoal hemoperfusion. The VAD was implanted by a surgical procedure in 14 patients, or by a technique similar to super-selective angiography mainly via the femoral artery in the remaining 16 patients who could not be operated on because of their seriously severe clinical condition and/or the difficulty involved in approaching the tumor feeding artery due to the presence of huge tumors or multiple lymph node metastasis. No serious complications were seen in these treatments. However, the catheter became occluded after an average post-implantation period of 9 months in 6 patients in the operative group. Since an operative procedure is very often too invasive for end-stage cancer patients and may enhance tumor growth, VAD implantation utilizing an angiographic technique is recommendable for the treatment of advanced cancer.